Endocrine and Metabolic Surgery (Thyrotoxicosis, Phaeochromocytoma, Adrenalectomy, and Bariatric Anaesthesia) — WACS Viva & Clinical Scenarios (General Anaesthesia)

Exam-style endocrine and metabolic surgery (thyrotoxicosis, phaeochromocytoma, adrenalectomy, and bariatric anaesthesia) viva scenarios with examiner probes…

Scenarios covered

• SCENARIO 1: A 36-year-old female with a large toxic multinodular goitre and retrosternal extension causing orthopnoea is scheduled for total thyroidectomy. Her resting heart rate is 115 bpm, and she has fine hand tremors. How do you evaluate her airway and cardiac status, optimize her to a euthyroid state, and manage her induction and extubation?
• SCENARIO 2: A 45-year-old male is scheduled for open left adrenalectomy for a 6 cm phaeochromocytoma. Outline your complete preoperative medical preparation criteria (Roizen criteria), your intraoperative monitoring and pharmacological plan for tumour manipulation, and your management of collapse following adrenal vein ligation.
• SCENARIO 3: A 40-year-old female with Cushing's disease secondary to a pituitary adenoma is scheduled for transsphenoidal hypophysectomy. Detail the multisystem pathophysiological abnormalities associated with hypercortisolaemia and your perioperative anaesthetic management, including intraoperative brain relaxation and perioperative steroid replacement.
• SCENARIO 4: A 42-year-old male with a BMI of 52 kg/m², poorly controlled Type 2 diabetes mellitus, and severe obstructive sleep apnoea is booked for laparoscopic Roux-en-Y gastric bypass. Walk the examiners through your pharmacokinetic dosing strategies, induction positioning, mechanical ventilation management, and post-extubation recovery protocol.